United States Bankruptcy Court NORTHERN DISTRICT OF ALABAMA

File Claim
Case Number
Example: 14-00002
 
Name of Creditor
Filed by

IMPORTANT NOTICE OF REDACTION RESPONSIBILITY: All filers must redact: Social Security or taxpayer-identification numbers; dates of birth; names of minor children; and financial account numbers, in compliance with Fed. R. Bankr. P. 9037. This requirement applies to all documents, including attachments.

Notice to Users: This is a restricted government system for official judiciary business only. All activities on this system for any purpose, and all access attempts, may be recorded and monitored or reviewed by persons authorized by the federal judiciary for improper use, protection of system security, performance of maintenance, and appropriate management by the judiciary of its systems. By using this system or any connected system, users expressly consent to system monitoring and to official access to data reviewed and created by them on the system. Any evidence of unlawful activity, including unauthorized access attempts, may be reported to law enforcement officials.

IMPORTANT WARNING: A person who files a fraudulent claim could be fined up to $500,000, imprisoned for up to 5 years, or both.
18 U.S.C. §§ 152, 157, and 3571.

I understand that, if I file, I must comply with the redaction rules. I have read this notice.


NOTE: This form should not be used to make a claim for an administrative expense arising after the commencement of the case. A "request" for payment of an administrative expense may be filed pursuant to 11 U.S.C. § 503.

IMPORTANT NOTICE: Do not upload a completed Proof of Claim form as an attachment.
Installed Version: 7